<![CDATA[Premarital health screening is widely promoted as a preventive strategy to improve maternal and child health; however, its implementation is often embedded within administrative procedures rather than preventive public health governance. Existing studies predominantly frame premarital screening as either a clinical intervention or a bureaucratic requirement, leaving a conceptual gap between governance practices and preventive counselling functions. This study addresses this gap by introducing the concept of preventive governance to examine how premarital health screening operates as preventive guidance and counselling within local public service delivery. Using a qualitative intrinsic case study in Kotawaringin Barat Regency, Indonesia, data were collected through in-depth interviews with health officials, religious affairs officers, health workers, and prospective couples, supported by observation and document analysis. Thematic analysis revealed a structural pattern characterized by procedural transparency, administrative accountability, and compliance-based participation. Although counselling and reproductive education were formally integrated into the screening process, participants largely perceived the service as an administrative prerequisite for marriage registration. Accountability mechanisms emphasized medical records and reporting systems, yet lacked longitudinal monitoring of preventive outcomes. Institutional coordination between health centres and the Office of Religious Affairs improved service access but remained constrained by workload pressures and the absence of integrated monitoring systems. These findings demonstrate a governance gap where premarital screening functions procedurally but has not fully evolved into preventive governance capable of fostering sustained preventive awareness and reproductive health literacy. This study contributes theoretically by conceptualizing preventive governance as an analytical framework that integrates governance principles, preventive health objectives, and counselling practices within local public services. Practically, the study highlights the need for outcome-oriented monitoring, strengthened preventive health literacy, and enhanced counselling capacity to transform administrative compliance into sustainable preventive health behaviour.]]>
